The way forward for low-income nations
We know what the COVID-19 vaccine controversies are, but there is an urgent need for an actual solution. The accusations are that rich nations are hoarding vaccines; this, notwithstanding the COVAX initiative under the auspices of the WHO to ensure vaccine equity. But COVAX neither barred rich nations from making side deals nor decided who can have what and when.
The words being used include ‘vaccine egotism’, ‘vaccine nationalism’, or even ‘vaccine scramble’ among others. What is surprising is that this surprises anyone at all.
As low-income nations ask for access to vaccines, they are being placed outside the priority lane because the First World’s needs must be served first. That seems to be the real meaning of the “First World” vs “The Rest”. It is bio-politically and bioethically objectionable but it is the reality with colonial roots.
How this protectionist idea is defended is that it will incentivize innovations. However, this is just political gymnastics. It is a way of saying what needs to be said without being too direct. Of course, this protectionist argument seems to be the only argument, and it is not incorrect. It is the only known rational approach to doing vaccine politics with ‘The Rest’. It has always been this way.
First, high income nations need to satisfy their constituents or the electorates as a sign of patriotism. They also need to satisfy the pharmaceutical industry. Both allow them to score political points with their base. It is only after this that they can engage in any form of vaccine diplomacy.
While this approach does not satisfy the expectations of most bioethicists in particular and the low-income nations in general, it has not stopped rich countries from refusing to relax patent rights for emergency purposes so that South Africa and India could make the vaccines just during the pandemic for their hard-hit populations. Here again, the reason for refusing this “unreasonable demand’ is to incentivize innovation by seeking rents on patents.
Of course, if the vulnerable populations worldwide could have access, it would be beneficial for all. International travel restrictions could be eased, and global commerce and hard-hit industries could resuscitate quickly. But as they say, beggars have no choice or better put, beggars can only have the choice given to them or they must create their own.
This leads me to the main issue. The number of vaccines we are having now were all produced in record time and there are several others in the pipeline. This has been made possible because the biotechnological infrastructure, including the medical innovation competence, and finances were made available by investors, donors, and government (subsidies). Scientists were already studying different vaccines, so it was easier to try something new such as an mRNA vaccine and to expedite the process.
This suggests that medical innovations are not instant magical conjectures. They result from several decades of scientific progress, which is paradoxically a global public good.
A grand opportunity for vaccine sovereignty
Low-income countries have an important old lesson to learn in these new times of global health crisis: each country for itself, God for us all.
One of the best problems that accompanied COVID-19 is that wealthy nations chose vaccine nationalism. Low-income nations have also come to terms (or at least so I hope) with the idea that when it comes to trade that will benefit the powerful multinationals, globalization and trade liberalization are ferociously promoted but for this all-important public health issue, we revert to nationalism.
This is precisely the opportunity countries may have been waiting for: to break free from an unhealthy relationship consisting of weakening dependency on one hand and an obsession with entitlement and saviourism on the other.
Who taught Africans to become this obsessed with dependency when the historical records show that Greeks’ Hippocrates came down to Khemet (‘the land of the blacks’, now Egypt) to learn medicine? In the same way, the first open heart surgery was performed by a black person as well as the first separation of Siamese (‘Gifted hands’). Also, the very idea of inoculation was brought by an African slave to Boston, Massachusetts which later became the standard practice and formed the foundations for modern science in vaccination in the late 1700s.
The strategy must be to create, empower and invest in local pharmaceutical industries. Support budding scientists. This is because it is clear that the vaccine or cure you help create is the only vaccine or cure you can access in record time by choice and not the one you can depend on from elsewhere based on someone’s benevolence. Things work like this in the age of responsibilization.
Meaningful returns on investment in self-sufficiency of vaccines
Creating your own choices has several advantages. You do it with your populations’ genetic make in mind; you know what’s in there (so you can avoid wild conjectures and conspiracy theories). You own it and most of all you will not be indebted to anyone with eternal gratitude or financial debt. If serendipity plays its role in science, it is possible to step into ground-breaking discoveries.
Low-income countries will then be free from victimhood and high-income nations will be disentangled from the ‘immortality projects’ of entitlement to control others through aid and philanthropy: this is just sustainability. Low-income countries will be inching closer to building national pharmaceutical industry and therefore joining the club of self-reliant regions and countries. It allows the national or regional brand to shine.
Here, low-income nations are not supposed to do what everyone does. Besides Western allopathic medicines, they can use herbal alternatives which have the potency to equally produce the desired results. They must test them and if that works then it simply means that each nation is free to use with an open-mind whatever their environment provides.
If a nation has no money, it is time to take full control of natural resources and seek rents which can be used for such important purposes as vaccine development even for the next outbreak. This simply means using what they have to get what they don’t have. It is never too late, especially if countries and regions can join forces.
China, Russia and others have excellent options too. And low-income nations can well consider those after testing them. In the meantime, non-pharmaceutical interventions along with health innovation policies can all help reduce the spread. It turns out there are more choices.
28 February 2021 – Frederick Ahen